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HIV Prevention, Young Gay Men of Color and the Fourth Wave of HIV Activism

November 15, 2013

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If behavioral interventions are not working, and biomedical interventions may be slow to take off, what does this spell for the future of this community? Current data predict that half of young black gay men could become positive in the next decade. Usher, doubtful of the data, said, "When you hear some of these statistics, you just have to be careful of how you're presenting it, and in what context. Are you saying we should be fixing something so this doesn't happen? Or is this what's going to happen with what we're doing now -- so let's just keep doing the same shit that we're doing and let it happen?"

Martinez was more encouraged to act than doubtful of the data. "If we don't fix this shit, if we don't have a bigger response to the epidemic now, this is what's going to happen."

How then do we find a way out of this bleak picture that the data seem to paint in broad, unforgiving strokes? Martinez sees hope in two options: finding new ways to capture data and mentorship.

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While Martinez understands societal factors like homophobia and stigma, and current interventions address the behavioral and the medical, he wants to quantify the psychosocial. "A little over two thirds of new HIV infections among MSM [men who have sex with men] were from people in committed relationships. If we keep using systemic oppression like homophobia and racism and sexism, what is it that we're missing?

"I want to find a way to measure what I consider the psychosocial. The love. I loved him; I trusted him. The validation. The self-esteem. I feel like there has to be some sort of research instrument that would allow us to really measure those things as drivers of HIV."

The conversation around condoms can only go so far in the context of relationships, especially because this context often implies condomless sex as the norm. "You cannot inject a condom into a person's life if they've consciously decided not to use them with their partner," said Usher. "Other people may not want to introduce condoms after sex without a condom with a partner." Current interventions usually consider the sex life of individuals who are single and do not take into account people in committed relationships, which leaves a huge part of many people's lives unexamined. Usher continued, "I think a lot of prevention has to be centered around harm reduction like we did for the drug-user population. We knew they were not going to stop using drugs; we made their drug use safer."

Usher similarly saw a need to address issues of mental health among young gay men of color. "I think we're so conditioned not to trust people, especially as we get older, that once we finally find somebody that we trust, or that we feel as if we trust, we let our guards down. Young black gay men aren't having a bunch of sex; it's just that we're having sex with people that we trust, people that we know, which puts us at risk."

"I want to find a way to measure what I consider the psychosocial. The love. I loved him; I trusted him. The validation. The self-esteem. I feel like there has to be some sort of research instrument that would allow us to really measure those things as drivers of HIV." -- Steven Emmanuel-Martinez

Usher also pointed out the lack of media-based blueprints for successful relationships as another reason that young black men often don't navigate relationships well. "When it comes to couples, especially as young black gay men, you don't see any true representation of what a successful relationship looks like."

As for the role of mentorship, all my interviewees spoke to the importance of having young gay men of color know as much about their sexual health as possible. "It starts when they're young," Steever said. "The schools play a role; sports teams and coaches play a role in this."

Johnson spoke of the importance of public agencies realizing that they are responsible to the people they serve and that prevention's priority must be to "empower communities to have a voice." As opposed to unequal power dynamics and damning prevention messaging that can induce paralysis, Martinez sees an opportunity for empowerment within existing social networks. "We listen to people who are in our immediate social network," Martinez said.

Many current prevention strategies revolve around intervening in the lives of young gay men of color -- their sex lives; their medical lives; their emotional, mental and psychological lives -- in hopes of preventing the spread of HIV. However, one thing has become abundantly clear in speaking with this group of advocates: If young gay men of color are to succeed, perhaps those not in that population require an intervention. If we are to implement a model of empowerment for young gay men of color, who are more and more "being empowered through their friends and social networks," then those most in need of an intervention are those who care for, interact with and nurture the souls of young gay men of color.

Each wave of HIV activism has taught the global community an important lesson regarding the health of queer people and the value of their lives. And with each subsequent wave, the lesson goes deeper. At first, activists taught about the importance of intervening in queer people's lives as they were on the brink of death; then activists found ways to fight for and win effective HIV treatment; and then advocacy focused more intently on the struggles of people living with HIV in resource-limited nations. With this emerging fourth wave, there are two potential lessons that activists can teach: First, they show us, by the example of HIV prevention, that factors impacting overall health need to be addressed before an event like HIV transmission occurs. Second, they remind us that supporting the health of young gay men of color is a community endeavor that demands a paradigm shift toward a prevention-minded society, and a palpable ethos of mutual care.

Mathew Rodriguez is the editorial project manager for TheBody.com and TheBodyPRO.com.

Follow Mathew on Twitter: @mathewrodriguez.


Copyright © 2013 Remedy Health Media, LLC. All rights reserved.
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